Learning the hard way indeed – original FOAMEd from Coroners court

foam-1

Hi folks

Latest South Australian Coroners Court finding on case of 11 month old Olivia Johnson who died of hypernatraemic dehydration due to gastroenteritis.

Here is LINK TO FINDING

Take home messages for the GP :

  1. In remote areas, think about what is backup plan if things deteriorate
  2. beware the premature infant with gastroenteritis
  3. If in doubt, check the electrolytes
  4. Consider when oral rehydration solutions may in fact worsen dehydration states
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2 thoughts on “Learning the hard way indeed – original FOAMEd from Coroners court

  1. Sometimes I have read previous Coroner’s recommendations and left feeling that they are either lacking in evidence base or practicality.

    I also think would I have done anything different with the subject of the Coroner’s report?
    Having worked in remote areas of the NT, I am left with a healthy respect for dehydration and electrolyte imbalances due to diarrhoea and vomiting in young children.

    Working currently on KI, most of my young patients have adequate reserve and I am yet to see a child close to the levels of unwellness as seen in the NT. I can see how that may lead to complacency and cutting corners.

    In this case I would have admitted the child for observation, made sure it was weighed because if the weight kept going down then that it bad, checked electrolytes, looked at its ecg and maybe even done a blood pressure. And then made a plan for oral hydration, IV or IO if I failed that. I also suspect I would have called a friend if the electrolytes were as bad as described.

  2. Having an iSTAT makes it easier – when in doubt or if parent live a long way, admit, trial of fluids, access and bloods/resus – maybe transfer. Phone a friend always helpful. But hindsight always 100%

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